Question

A patient with a new diagnosis of ischemic stroke is deemed to be a candidate for treatment with tissue plasminogen activator (t-PA) and has been admitted to the ICU. In addition to closely monitoring the patient's cardiac and neurologic status, the nurse monitors the patient for signs of what complication?

A. Acute pain.
B. Septicemia.
C. Bleeding.
D. Seizures.

Answer 1

The nurse should monitor for signs of C. bleeding in a patient receiving tissue plasminogen activator (t-PA) for ischemic stroke. Bleeding is a critical complication due to the thrombolytic function of t-PA, and vigilance is necessary to detect and manage any hemorrhagic events.

Step-by-step explanation:

In a patient with a new diagnosis of ischemic stroke who is a candidate for treatment with tissue plasminogen activator (t-PA) and has been admitted to the ICU, the nurse would closely monitor for signs of bleeding. Tissue plasminogen activator (t-PA) is a thrombolytic agent that works by catalyzing the conversion of plasminogen to plasmin, which then degrades blood clots. While t-PA can significantly improve the prognosis when administered within a critical time window after a thrombotic stroke, its mechanism of action increases the risk of bleeding. This is a life-threatening complication, particularly of intracerebral hemorrhage, that must be vigilantly monitored for during and after administration of t-PA.

Strokes can be caused by thrombi or hemorrhages, so determining the stroke's etiology is critical before administering t-PA. In cases of ischemic stroke, rapid restoration of blood flow is crucial to salvage the potentially recoverable brain tissue in the ischemic penumbra. Proper monitoring enables healthcare providers to manage complications promptly and improve the chances of patient recovery.